PEDIATRIC EPILEPSY: Seizures in Children


Alise Owens, MSN, RN, FNP-BC
Family Nurse Practitioner 
Comprehensive Epilepsy Program
Pediatric Neurology at Texas Children's Hospital

Editor's Note: Straight from the Source is a series. These Question and Answer sessions allow readers access to the thoughts of Houston's top experts.
ParentsPost:  What is epilepsy?

ALISE OWENS:  Epilepsy is a medical condition characterized by recurrent seizures.  A seizure is a sudden, uncontrollable, electrical change in the brain.  Depending on the part of the brain affected, the seizures can have a variety of features.  If a person has two or more seizures that are not triggered by an identifiable cause such as low blood sugar or acute head trauma, they are classified as having epilepsy.  Nearly 3 million Americans have epilepsy and 200,000 people are diagnosed each year.  As of 2011, approximately 326, 000 children under the age of 15 years living in the United States have epilepsy.  

ParentsPost:  What are the signs that a child has epilepsy? How do you know a child is having a seizure?

ALISE OWENS:  The characteristics of a seizure vary depending on the origin in the brain, the type of seizure, and the age of the child.  A seizure could involve brief staring spells.  A seizure could cause the child to look confused, wander aimlessly and make random vocalizations.  Other seizures give the appearance of rhythmic muscle jerking and stiffening of extremities.  Some seizures cause the child to suddenly fall to the ground.  Many, but not all, seizures involve a loss of consciousness.  Seizures can last from seconds to hours.  Fortunately, most seizures are brief and rarely last more than 5 minutes.  It is usually not difficult to identify a seizure.  Some clues include not responding when touched, abnormal uncontrollable movements, and sedation or a bad headache after the event.

ParentsPost:  How is epilepsy diagnosed? What are the tests and who are the doctors involved? 

ALICE OWENS:  Epilepsy is diagnosed by a thorough medical history and physical examination.  An electroencephalogram (EEG) is also helpful to look at the electrical activity in the brain.  A MRI of the brain can determine if there is any brain abnormality likely to cause seizures.  Certain blood tests can also be helpful in diagnosing epilepsy.  Childhood epilepsy may be diagnosed and treated by a neurologist, child neurologist, or a nurse practitioner with special training in child neurology.  Other providers who may be involved include neurosurgeons, neuropsychologists, and geneticists. 

ParentsPost:  What are treatment options available for children?

ALISE OWENS:  Medication is the first-line treatment for epilepsy.  If a child has one seizure, he or she is usually not started on medications and may only be monitored clinically.   The majority of persons who have a single seizure do not develop epilepsy.  Ten percent of all Americans will experience a seizure.  If medications do not work to control the seizures, other options include epilepsy surgery, a Vagus Nerve Stimulator (VNS), and the Ketogenic diet. 

ParentsPost:  Can you prevent seizures or reduce risks of a seizure?

ALISE OWENS:  Although it is not possible to prevent a seizure, there are ways to reduce the likelihood of having a seizure.  Missing medications is a very common trigger for seizures in a person who is otherwise doing well.  Another factor is poor sleeping habits and not getting enough rest.  Fever and illness are also big triggers for seizure breakthrough.  Other factors include stress, dehydration, and poor nutrition.  

ParentsPost:  What are the safety issues concerning children with epilepsy?

ALISE OWENS:  The risk of injury during a seizure is a main concern.  Some children can fall suddenly and hit their heads or break bones.  Children with complex partial seizures, seizures that cause wandering and altered awareness, can wander out of the house and into busy streets.  Children with seizures may also be injured by bystanders trying to help.  For example, someone placing an object in an actively seizing child's mouth can cause choking or fractured teeth.  Emergency personnel generally do not need to be called for seizures in a child with a known diagnosis of epilepsy.  If the seizure lasts more than 5 minutes or if it is the child's first seizure, 911 should be summoned. 

ParentsPost:  What are some unique school issues that children with epilepsy may encounter? 

ALISE OWENS:  Children with epilepsy may have difficulty with school.  Persons with epilepsy have a higher incidence of other conditions such as ADHD.  The medications can cause some cognitive slowing, making completing schoolwork and taking examinations difficult.   Some children require resource help or even special education.  School officials can also place restrictions on children with epilepsy and not allow them to participate fully in school activities.  Many schools will not allow children to participate in physical education, attend field trips, or play on team sports just because they have epilepsy.  Fear and lack of understanding of epilepsy by school officials can create unique school issues for kids with epilepsy.  

ParentsPost:  How do you help a child who may be having a seizure?

ALISE OWENS:  The first thing is to remain calm.  For seizures involving loss of consciousness and muscle shaking, place something flat and soft under the child's head and roll him or her on the side.  Do not place anything in the mouth of someone having a seizure.  Do not restrain the person.  If a child is conscious but appears confused and is not responding, just keep him or her safe from objects and try to redirect their movements to contain them in a safe environment.  If the seizure lasts more than 5 minutes, call 911. 

ParentsPost:  Can a child with epilepsy be active in sports?

ALISE OWENS:  Most children can participate in sports with a few limitations.  The best sports are more individual sports such as tennis and running.  Children can play football and soccer but must be seizure-free for a period of time usually 6–12 months.  Children can swim if there is a person assigned to monitor the child when in the pool.  Children can ride bikes if they where a helmet. 

ParentsPost:  Is epilepsy life-long or can it be treated and disappear?

ALISE OWENS:  The majority of the children who develop epilepsy will outgrow it and will no longer have seizures as adults.  Nearly 70% of individuals with epilepsy will become seizure-free.  After 2 years of seizure freedom while taking medications, children are weaned from medications and most remain seizure-free.  Depending on the cause of the seizure, some children will have epilepsy into adulthood. 

ParentsPost:  Are there support groups for families with children who have epilepsy?

ALISE OWENS:  The local Epilepsy Foundation has programs to support children and families dealing with epilepsy.  Nearly every state has epilepsy summer camps for children.  These camps are free to the participants, staffed by child neurologists and nurse practitioners and allow the children to have a "regular" camp experience.  There are also weekend family camps throughout the year that give families the opportunity to get a weekend away and foster support networks.  

ParentsPost:  What else is important to know about children with epilepsy?  

ALISE OWENS:  Children with epilepsy are regular kids who are like many others with chronic illnesses.  There are some accommodations that need to be made to manage the epilepsy but they should not be excluded from typical childhood activities. 


Houston family news links

5/1/2018 9:05:00 AM

3/28/2018 7:20:00 PM

3/28/2018 7:13:00 PM

sign up for calendar alerts

Type Numeric Code Below:
CAPTCHA Generator